HB488 / SB547, HB527 / SB524, SB543
Health Insurance Mandates / Life Insurance

The Massachusetts Health & Hospital Association (MHA), on behalf of our member hospitals, health systems, physician organizations, and allied healthcare providers, appreciates the opportunity to submit comments regarding legislation that would improve insurer coverage for children’s mental health treatment and provide coverage for medication assisted treatment to combat the state’s opioid epidemic.

MHA strongly supports HB488/SB547, which requires coverage and home-based behavioral healthcare services, also known as “wraparound care”, for children and adolescents with mental health disorders who are covered by commercial insurance. Currently, these services are only available to children with MassHealth and their families through the Children’s Behavioral Health Initiative (CBHI). The children of families with commercial insurance either go without these services, or use “secondary MassHealth” to obtain these services.

One in five children and adolescents experiences symptoms of a diagnosable mental health disorder each year. Half of all lifetime mental illnesses begin by age 14 (with 75% beginning by age 24). Among children ages 9 to 17, 11% experience significant impairment from mental illnesses and 5% experience extreme functional impairment. In 2008, the state implemented the Children’s Behavioral Health Initiative (also known as the Rosie D. remediation), which reflected the recognition that children and adolescents in Massachusetts who suffer from mental illness needed access to community-based services in order to minimize the need for inpatient services. Yet families who have commercial insurance should not need MassHealth in order to access services for their children. Right now, families pay MassHealth premiums to access wraparound care through the CBHI. Yet the community- based care that wraparound services provide, including therapy in community settings, specialist consults, ongoing staff support and psychological evaluations, can prevent costly hospitalization of these children. The state shouldn’t have to pay for services that should be covered by commercial insurance plans. Therefore, MHA urges the committee to give a favorable report to HB488/SB547 at its earliest convenience.

MHA strongly supports HB527/SB524, which will improve coverage of, and access to, educational psychologists for children. The ability to obtain appropriate coverage and access to mental health services for children, both inside and outside of public and private facilities, continues to be a major concern in the Commonwealth. This situation has become even more pronounced as a result of: decreases in funding for community-based services; health insurers increasingly refusing to recognize many primary care clinicians who offer treatment options in the community; and a lack of parity between medical and mental health coverage options. HB527/SB524 would ensure that health insurers recognize and reimburse for services provided by educational psychologists in a community-
based setting for children. Because of the challenge presented by the lack of adequate coverage for child mental health services, it is very important that health insurers allow other licensed care providers such as educational psychologists to ensure continuity of care to children in the community.

MHA also supports SB543 which seeks to require insurer coverage for medication assisted treatment programs and the goal to limit out-of-pocket costs for such treatment. Such coverage and limits on out-of-pocket payments for patients would be an additional important tool in the state’s efforts to combat the opioid epidemic.

Thank you for the opportunity to offer testimony on this important matter. If you have any questions regarding this testimony or require further information, please contact Michael Sroczynski, MHA’s Vice President of Government Advocacy, at (781) 262-6055 or msroczynski@mhalink.org.